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Raloxifene Therapy and Risk of Breast Cancer
In the Multiple Outcomes of Raloxifene Evaluation
trial, Cummings and colleaguesArticle found that after a median of 40 months,
postmenopausal women with osteoporosis who received raloxifene had a
significantly lower cumulative incidence of breast cancer than women
who received placebo (Figure 1). In an editorial, Franks and SteinbergArticle discuss the treatment implications of these findings and the continued
uncertainty about the cardioprotective and cognitive benefits of
estrogen therapy in postmenopausal women.
Why Are Drowning Rates Declining?
Mortality from unintentional drowning has decreased in the United
States during the past several decades. In this analysis of cases of
submersion injuries in King County, Washington, Cummings and QuanArticle found
that drowning mortality rates declined 59% between 1975 and 1995,
explained in part by decreases in the severity of submersion episodes
and in the use of alcohol around water, but not by improvements in
prehospital and hospital care. In an editorial, Smith and HowlandArticle
explore various explanations for the declining rate of deaths from
Potassium Level and Perioperative Arrhythmia Risk
Correction of abnormal serum potassium levels prior to cardiac surgery
may reduce the risk of adverse perioperative events. Wahr and coworkers
report that perioperative arrhythmias occurred in 1290 (54%) of 2402
patients undergoing elective coronary artery bypass graft surgery. A
preoperative serum potassium level of less than 3.5 mmol/L was
associated with a significantly increased risk of serious perioperative
arrhythmias (those requiring intraoperative treatment or combined
postoperative ventricular and atrial arrhythmias), intraoperative
arrhythmias, and postoperative atrial fibrillation/flutter.
Carrier Rates of Mutations Causing Inherited Deafness
Mutations in the GJB2 gene are the most common known cause of
inherited congenital severe-to-profound deafness. Based on genetic
screening of 52 children with moderate-to-profound congenital
sensorineural hearing loss and 560 control neonates, Green and
colleagues estimate that the carrier rate for the 35delG mutation of
the GJB2 gene is 2.5% and for all recessive deafness-causing
GJB2 mutations, 3.01%.
Laboratory Detection of Iron Deficiency in Children
Iron deficiency anemia in young children has been associated with
cognitive and motor developmental deficits that persist even after the
anemia is corrected. To determine the optimal approach for the
laboratory diagnosis of iron deficiency and iron deficincy anemia,
Brugnara and colleaguesArticle tested the blood samples drawn for lead
screening of 210 children, mean age 2.9 years, using several
conventional and newer biochemical and hematological indices. They
found that the reticulocyte hemoglobin content was the best predictor
of both iron deficiency and iron deficiency anemia in children. In an
editorial, CohenArticle points out that better clinical and public health
interventions may offer more to prevent and detect iron deficiency in
young children than an improved screening test.
A Piece of My Mind
"A single rise, a single missed opportunity, is all the stream
chooses to yield this evening." From "Cold Blue."
Base pair inserts in the reverse transcriptase gene of the human
immunodeficiency virus develop during antiretroviral therapy and result
in resistance to many nucleoside reverse transcriptase inhibitors.
Medical News & Perspectives
As the prevalence of asthma increases, the medical community continues
to seek causes and treatment and prevention strategies.
Mak and colleagues find that routine testing for common mutations in
the cystic fibrosis transmembrane conductance regulator (CFTR)
gene may miss about 40% to 80% of detectable mutations in the
CFTR gene in men with obstructive azoospermia.
The Rational Clinical Examination
How to detect aortic regurgitation.
JAMA Editorial Governance Plan
TheJAMA Editor Search Committee and AMA Board of Trustees and
senior staff agree on a governance plan for JAMA and the
JAMA Patient Page
For your patients: Water safety tips.
This Week in JAMA. JAMA. 1999;281(23):2165. doi:10.1001/jama.281.23.2165
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